A recent study led by the National Institutes of Health (NIH) and published in JAMA Oncology highlights the significant impact of prevention and screening in reducing mortality from five major cancer types over the last 45 years. The research focused on breast, cervical, colorectal, lung, and prostate cancers, which collectively represent nearly half of all cancer diagnoses and deaths. This study underscores that while treatment advances are often viewed as the primary contributors to mortality reduction, prevention and screening have played a more substantial role in saving lives.

Co-lead investigator Katrina A. B. Goddard, Ph.D., from the NCI's Division of Cancer Control and Population Sciences, emphasized that 80% of the deaths averted from these cancers since 1975 can be attributed to advances in prevention and screening rather than treatment. Particularly notable is the impact of smoking cessation, which alone accounted for 3.45 million lives saved from lung cancer. The study further found that prevention and screening were the predominant factors in reducing deaths from cervical, colorectal, lung, and prostate cancers, while treatment advances led in breast cancer mortality reduction.

The study utilized statistical models to analyze cancer mortality data between 1975 and 2020, revealing that 5.94 million deaths were prevented due to interventions in these five cancers, with prevention and screening accounting for 4.75 million of these. The breakdown by cancer type showed varying contributions of screening and treatment. For example, in lung cancer, tobacco control was overwhelmingly effective, accounting for 98% of the averted deaths. Conversely, in breast cancer, treatment was the major contributor, although mammography screening also played a significant role.

These findings underscore the necessity of a multifaceted approach to cancer reduction, combining effective prevention, screening, and treatment strategies. W. Kimryn Rathmell, M.D., Ph.D., director of NCI, stated that understanding which strategies are most effective helps guide future efforts to reduce cancer mortality further. The study also points to recent advancements like HPV vaccination and lung cancer screening, which could potentially enhance these effects even though they were not widely used during the study period.

However, the researchers acknowledge that the study's focus on these five cancers, which represent less than half of all cancer deaths, means the findings might not apply to cancers without effective prevention, screening, or treatment options. Dr. Philip E. Castle, another co-lead investigator, emphasized the importance of optimizing and expanding access to proven interventions, particularly for underserved populations, and developing new strategies for other lethal cancers such as pancreatic and ovarian cancer.

The authors also noted limitations, including the study's reliance on population averages and its exclusion of potential screening harms like false positives and overdiagnosis. These findings present a complex picture of cancer prevention and treatment, highlighting the critical role of integrated strategies in ongoing efforts to reduce cancer mortality across various populations.  

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